Comparison of outcomes in cataractous eyes of dogs undergoing phacoemulsification versus eyes not undergoing surgery.

PubMed ID: 31746126

Author(s): Krishnan H, Hetzel S, McLellan GJ, Bentley E. Comparison of outcomes in cataractous eyes of dogs undergoing phacoemulsification versus eyes not undergoing surgery. Vet Ophthalmol. 2020 Mar;23(2):286-291. doi: 10.1111/vop.12724. Epub 2019 Nov 20. PMID 31746126

Journal: Veterinary Ophthalmology, Volume 23, Issue 2, Mar 2020

OBJECTIVE To compare outcomes of surgical intervention and nonsurgical management of canine cataracts.

METHODS Records of patients examined for cataracts from January 2007 to February 2018 were divided into two groups: nonsurgical and surgical. The nonsurgical group was further subdivided based on whether the decision not to pursue surgery was elected by owners, or based on ophthalmologist’s advice. Inclusion criteria included 6 months of follow-up. Success in the nonsurgical group was defined as a comfortable eye with no potentially painful complications, and success in the surgical group additionally required vision. Time-to-failure (complications) was assessed with Cox proportional hazards models.

RESULTS A total of 72 eyes (41 dogs) were included in the nonsurgical group, and 126 eyes (67 dogs) were surgically treated. There was no difference in gender or age; however, the surgical group had significantly more diabetic eyes (56.3% vs 15.3%; P < .001) and patient eyes with longer follow-up times (median 37.6 months vs 22.1 months; P < .001) than the nonsurgical group. There was no statistically significant difference in complication rates between the nonsurgical group (15/72 [20.8%]) and the surgical group (23/126 [18.3%]; HR: 2.22 [0.97, 5.0]; P = .060). However, the complication rate in the ophthalmologist-led nonsurgical group was significantly greater than in the owner-led nonsurgical group (P = .019) and the surgical group (P = .002).

CONCLUSIONS When using relevant outcomes, whether or not a cataractous eye has surgery does not affect long-term complications; additionally, nonsurgical eyes that are poor surgical candidates have a higher complication rate than eyes deemed suitable for phacoemulsification for which owners elected not to pursue cataract surgery.